Sriwijaya Journal of Ophthalmology

Eyelid Squamous Cell Carcinoma in Palembang, Indonesia: A 5-Year Retrospective Study

Zahratul Riadho — 2025-02-11

Introduction: Eyelid squamous cell carcinoma (SCC) is a prevalent malignancy with potentially severe consequences if not detected and managed early. This study aimed to investigate the prevalence, clinical characteristics, and histopathological features of eyelid SCC patients at Dr. Mohammad Hoesin General Hospital Palembang, Indonesia, over a 5-year period.

Methods: A retrospective analysis of medical records was conducted on 20 patients diagnosed with eyelid SCC between 2020 and 2024. Data on demographics, clinical presentation, tumor characteristics, and histopathological findings were collected and analyzed. Univariate analysis was performed to describe the characteristics of the study population. Correlation tests were conducted to explore the relationships between various factors and eyelid SCC.

Results: The prevalence of eyelid SCC was 16.67%, with the highest incidence in 2024 (25%). The majority of patients were ≥ 50 years old (60%), with an equal distribution between males and females. Outdoor occupations (45%) and lower education levels (60% with primary education) were common characteristics. Lesions were mostly multiple (45%), >3cm in size (55%), and located on the right side (60%). Histopathological analysis revealed well-differentiated (25%) and poorly differentiated (25%) SCC as the most common subtypes. Correlation analysis revealed significant associations between age and tumor size, occupation and tumor size, education level and tumor size, smoking status and differentiation, tumor size and lymphovascular invasion, and perineural invasion and differentiation.

Conclusion: Eyelid SCC in Palembang predominantly affects older individuals with outdoor occupations and lower education levels. Multiple, large, and right-sided lesions are frequent findings. Emphasis on sun protection and early detection is crucial, particularly for outdoor workers.

Neutrophil-to-Lymphocyte Ratio as a Predictive Biomarker for Retinopathy of Prematurity: A Systematic Review

Ayu Diah Permatasari — 2025-07-14

Introduction: Retinopathy of prematurity (ROP) remains a leading cause of childhood blindness, with its pathogenesis linked to aberrant vascular development and systemic inflammation. There is a critical need for accessible biomarkers to improve risk stratification beyond current screening standards. This systematic review critically appraises the evidence for the neutrophil-to-lymphocyte ratio (NLR), a widely available inflammatory marker, as a predictor of ROP.

Methods: Following PRISMA 2020 guidelines, a systematic search was conducted in PubMed, ScienceDirect, ProQuest, and SpringerLink for observational studies published between January 1^st, 2015, and December 31^st, 2024. Studies assessing the association between NLR and ROP in preterm infants were included. Two reviewers independently performed study selection, data extraction, and a formal risk-of-bias assessment using the Newcastle-Ottawa Scale (NOS). A narrative synthesis was performed due to significant heterogeneity.

Results: The search identified 32 records, with 6 retrospective studies ultimately meeting the inclusion criteria, encompassing a total reported sample of 1,065 infants. The methodological quality of the included studies was low to moderate, with NOS scores ranging from 5 to 7 out of a possible 9. The evidence base was defined by profound methodological heterogeneity, particularly in the timing of blood sample collection, which was unspecified in half of the studies, and inconsistent reporting of core population data. A narrative synthesis of the findings showed that several studies reported a statistical association between an elevated NLR or related inflammatory markers and ROP. However, one study reported no significant association, and the interpretation of others was complicated by a focus on different biomarkers or a lack of statistical significance.

Conclusion: The available evidence, derived exclusively from retrospective studies of varying quality, suggests a possible association between elevated NLR and ROP, a link supported by strong biological plausibility. However, the current evidence base is severely limited by methodological flaws and profound heterogeneity, making it insufficient to support the adoption of NLR into clinical practice. NLR is not a standalone diagnostic or predictive tool for ROP. Its potential utility can only be realized through large-scale, methodologically rigorous prospective studies designed to overcome the limitations identified in this review.

Navigating Therapeutic Challenges in Adult-Onset Coats' Disease: Successful Vitrectomy for Tractional Retinal Detachment Following Laser Photocoagulation

Albatool Alqahtani — 2025-07-25

Introduction: Adult-onset Coats' disease, an infrequent variant of idiopathic exudative retinopathy, presents a unique management paradigm. While laser photocoagulation is a primary treatment for the characteristic retinal telangiectasia, it can paradoxically trigger a severe inflammatory and fibrotic cascade, leading to vision-threatening complications. This report addresses a critical clinical question: What is the optimal management strategy when first-line ablative therapy not only fails but leads to iatrogenic tractional retinal detachment?

Case presentation: A 35-year-old male presented with a 15-day history of metamorphopsia in his right eye. Best-corrected visual acuity (BCVA) was 20/20. Multimodal imaging confirmed Stage 2B Coats' disease. Following sectoral argon laser photocoagulation, his BCVA declined to a nadir of 20/60. Within two months of laser, optical coherence tomography (OCT) documented the rapid development of an epiretinal membrane and a subsequent superior macular tractional retinal detachment (TRD). A 23-gauge pars plana vitrectomy (PPV) with membrane peeling was performed. Anatomical success was achieved, and at the six-month follow-up, the retina remained attached, and BCVA improved to 20/40.

Conclusion: This case demonstrates that laser-induced inflammation can rapidly convert an exudative process into a complex fibro-proliferative state in adult-onset Coats' disease. When confronted with iatrogenic fibrosis, medical management is insufficient. This report validates that timely and definitive surgical intervention with PPV is not merely an option but an essential strategy for reversing the disease trajectory, achieving anatomical restoration, and salvaging vision.